Abstract:
STUDY OBJECTIVE:Ultrasonographically guided intravenous peripheral catheters have dismal dwell time, with most intravenous lines failing before completion of therapy. Catheter length in the vein is directly related to catheter longevity. We investigate the survival of an ultralong ultrasonographically guided intravenous peripheral catheter compared with a standard long one. METHODS:We conducted a single-site, nonblinded, randomized trial of catheter survival. Adult patients presenting to the emergency department with difficult vascular access were recruited and randomized to receive either standard long, 4.78-cm, 20-gauge ultrasonographically guided intravenous peripheral catheters or ultralong, 6.35-cm, 20-gauge ultrasonographically guided intravenous peripheral catheters. The primary outcome was duration of catheter survival. The secondary outcome was the optimal length of the catheter in the vein to maximize survival. Additional intravenous-related endpoints included first-stick success, time to insertion, number of attempts, thrombosis, and infection. RESULTS:Between October 2018 and March 2019, 257 patients were randomized, with 126 in the standard long ultrasonographically guided intravenous peripheral catheter group and 131 in the ultralong group. Kaplan-Meier estimate of catheter median survival time in the ultralong group was 136 hours (95% confidence interval [CI] 116 to 311 hours) compared with 92 hours (95% CI 71 to 120 hours) in the standard long group, for a difference of 44 hours (95% CI 2 to 218 hours). The optimal catheter length in the vein was 2.75 cm, and intravenous lines with greater than 2.75 cm inserted had a median survival of 129 hours (95% CI 102 to 202 hours) compared with 75 hours (95% CI 52 to 116 hours) for intravenous lines with less than or equal to 2.75 cm, for a difference of 54 hours (95% CI 10 to 134 hours). Insertion characteristics were similar between the groups: 74.1% versus 79.4% first-stick success (95% CI for the difference -2% to 5%), 1.4 versus 1.3 for number of attempts (95% CI for the difference -0.1 to 0.3), and 6.9 versus 5.9 minutes to completion (95% CI for the difference -1.3 to 3.4) with ultralong versus standard long, respectively. There were no cases of infection or thrombosis. CONCLUSION:This study demonstrated increased catheter survival when the ultralong compared with the standard long ultrasonographically guided intravenous peripheral catheter was used, whereas insertion characteristics and safety appeared similar.
journal_name
Ann Emerg Medjournal_title
Annals of emergency medicineauthors
Bahl A,Hijazi M,Chen NW,Lachapelle-Clavette L,Price Jdoi
10.1016/j.annemergmed.2019.11.013subject
Has Abstractpub_date
2020-08-01 00:00:00pages
134-142issue
2eissn
0196-0644issn
1097-6760pii
S0196-0644(19)31383-6journal_volume
76pub_type
杂志文章,随机对照试验abstract:STUDY OBJECTIVE:To evaluate the safety of lidocaine in the setting of cocaine-induced myocardial infarction (MI). DESIGN:A retrospective, multicenter study. SETTING:Twenty-nine university, university-affiliated, or community hospitals during a 6-year period (total of 117 cumulative hospital-years). PARTICIPANTS:Pati...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,多中心研究
doi:10.1016/s0196-0644(95)70041-2
更新日期:1995-12-01 00:00:00
abstract:STUDY OBJECTIVE:We derive a prediction rule to identify children at very low risk for intra-abdominal injuries undergoing acute intervention and for whom computed tomography (CT) could be obviated. METHODS:We prospectively enrolled children with blunt torso trauma in 20 emergency departments. We used binary recursive ...
journal_title:Annals of emergency medicine
pub_type: 临床试验,评论,杂志文章,多中心研究
doi:10.1016/j.annemergmed.2012.11.009
更新日期:2013-08-01 00:00:00
abstract:STUDY OBJECTIVE:For an emergency medicine pharmacist to become a well-integrated multidisciplinary team member, his or her services need to be accepted by the emergency department (ED) staff. There have been 2 published studies attesting the value of the emergency medicine pharmacist by ED staff: at an academic medical...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2016.08.451
更新日期:2017-03-01 00:00:00
abstract:STUDY OBJECTIVE:To compare the speed of IV access and the rate of infusion for saphenous venous cutdown and percutaneous femoral catheterization. DESIGN:Prospective, randomized, multicentered trial. Patient enrollment occurred from September 1990 through September 1991. SETTING:Patients were enrolled at three urban L...
journal_title:Annals of emergency medicine
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1016/s0196-0644(94)70074-5
更新日期:1994-03-01 00:00:00
abstract:STUDY OBJECTIVE:Medication history is an essential part of patient assessment in emergency care. Patient-reported medication history can be incomplete. We study whether an electronic pharmacy-sourced prescription record can supplement the patient-reported history. METHODS:In a community hospital, we compared the patie...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2013.04.014
更新日期:2013-09-01 00:00:00
abstract:STUDY OBJECTIVE:To derive a highly sensitive decision rule for the selective use of radiography in acute knee injuries. DESIGN:Prospectively administered survey. SETTING:Emergency departments of two university hospitals. PARTICIPANTS:Convenience sample of 1,047 adults with acute knee injuries. RESULTS:Attending eme...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(95)70106-0
更新日期:1995-10-01 00:00:00
abstract:STUDY OBJECTIVE:We seek to examine the effectiveness of the graduated driver licensing system in Utah by determining whether crash rates of 16-year-old drivers decreased after graduated driver licensing implementation. METHODS:We studied 16-year-old-driver crashes using statewide motor vehicle crash data probabilistic...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2004.10.007
更新日期:2005-02-01 00:00:00
abstract::We report 2 deaths and 1 injury that resulted from 2 separate unintentional discharges of the same Ruger Blackhawk revolver. One discharge was a consequence of careless firearm handling combined with a slip during a decocking procedure unique to certain hammer-action firearms. The second discharge occurred when the fi...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1067/mem.2001.112251
更新日期:2001-03-01 00:00:00
abstract::This is a report of a patient who survived a large propranolol overdose, as documented by toxic blood levels. The signs and symptoms were those of profound inotropic and moderate chronotropic cardiotoxicity which failed to respond to parasympatholytics or catecholamines, but subsequently reversed coincident with the a...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(80)80436-7
更新日期:1980-01-01 00:00:00
abstract:STUDY OBJECTIVES:To characterize the attendance at and presenters of conferences given to emergency medicine residents and to determine the ability of emergency medicine residents to attend conferences while working in the emergency department and on off-service rotations. DESIGN:Descriptive study of an anonymous mail...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(95)70288-1
更新日期:1995-03-01 00:00:00
abstract:STUDY OBJECTIVE:We estimate the test characteristics of nasogastric aspiration to diagnose upper gastrointestinal tract hemorrhage in patients without hematemesis. METHODS:In this retrospective cohort study, medical records from patients admitted to 2 urban hospitals between 1997 and 2002 for gastrointestinal tract bl...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2003.09.002
更新日期:2004-04-01 00:00:00
abstract:STUDY OBJECTIVE:Adverse drug events represent the most common cause of preventable nonsurgical adverse events in medicine but may remain undetected. Our objective is to determine the proportion of drug-related visits emergency physicians attribute to medication-related problems. METHODS:This prospective observational ...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2009.10.008
更新日期:2010-06-01 00:00:00
abstract:STUDY OBJECTIVE:Factors associated with intraosseous (IO) catheterization are not well described. Our objective is to identify factors associated with the attempt and timing of IO catheterization in a pediatric emergency department (ED) resuscitation setting. METHODS:We completed a video-based, case-control study (1:3...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2019.09.005
更新日期:2020-06-01 00:00:00
abstract:STUDY OBJECTIVE:Crisis resource management skills are integral to leading the resuscitation of a critically ill patient. Despite their importance, crisis resource management skills (and their associated cognitive processes) have traditionally been difficult to study in the real world. The objective of this study was to...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2018.03.005
更新日期:2018-09-01 00:00:00
abstract::The epidemiology of pediatric fever has changed considerably during the past 2 decades with the development of vaccines against the most common bacterial pathogens causing bacteremia and meningitis. The decreasing incidence of these 2 conditions among vaccinated children has led to an emphasis on urinary tract infecti...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,评审
doi:10.1016/j.annemergmed.2012.10.034
更新日期:2013-05-01 00:00:00
abstract:STUDY OBJECTIVE:This study was conducted to compare the clinical and spirometric effects of continuous and intermittent nebulization of salbutamol in acute severe asthma. METHODS:Forty-two consecutive patients presenting to the emergency department for acute severe asthma (peak expiratory flow [PEF] mean+/-SD, 24%+/-1...
journal_title:Annals of emergency medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1067/mem.2000.109169
更新日期:2000-09-01 00:00:00
abstract::To evaluate the heat burden in parked cars, a study was done to measure inside car temperatures in different situations. A large car and a small car were parked in direct sunlight and in shade. In direct sun, the highest temperatures recorded in the small and large cars were 78 C and 65 C, respectively. The highest te...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(82)80097-8
更新日期:1982-05-01 00:00:00
abstract:STUDY OBJECTIVE:To determine whether N-acetylcysteine (NAC reduces methemoglobin. METHODS:We carried out an in vitro laboratory experiment in which five healthy adult volunteers donated blood. Each sample was divided equally among three test tubes. Tube 1 served as a negative control. Sodium nitrite .18 mol/L with dex...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(96)70112-9
更新日期:1996-11-01 00:00:00
abstract:STUDY OBJECTIVE:Availability of timely follow-up care is essential in emergency medicine. We describe nonprice barriers to care experienced by callers reporting to be emergency department (ED) patients in need of follow-up care. METHODS:This was a secondary analysis of data collected during a survey of ambulatory clin...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.annemergmed.2007.10.027
更新日期:2008-05-01 00:00:00
abstract::An important responsibility of emergency departments is the management of injuries sustained in assaults. Most assaults, including many causing serious injury, are not reported and not recorded by the police. This is important because police investigation and the conviction of offenders has a substantial deterrent eff...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,评审
doi:10.1067/mem.2001.114317
更新日期:2001-10-01 00:00:00
abstract:STUDY OBJECTIVE:Recent systematic reviews have noted a lack of evidence that screening for intimate partner violence does more good than harm. We assess whether patients screened for intimate partner violence on a computer kiosk in the emergency department (ED) experienced any adverse events during or subsequent to the...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2007.11.019
更新日期:2008-04-01 00:00:00
abstract:STUDY OBJECTIVE:Single-payer health care is supported by most Americans, but the effect of single payer on any particular sector of the health care market has not been well explored. We examine the effect of 2 potential single-payer designs, Medicare for All and an alternative including Medicare and Medicaid, on total ...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2020.03.003
更新日期:2020-10-01 00:00:00
abstract:STUDY OBJECTIVE:To compare the effectiveness and incidence of adverse reactions with three treatment regimens for asthma in adults in the prehospital setting. DESIGN:Prospective, randomized clinical study. SETTING:Inner-city emergency medical service system providing basic and advanced life support and transport to 1...
journal_title:Annals of emergency medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0196-0644(95)70116-8
更新日期:1995-10-01 00:00:00
abstract::Intravenous (IV) fibrinolytic therapy, a recent area of research, has a great deal of applicability in emergency medicine. We report our experience with 30 patients treated with this method. Thirty consecutive patients in the early stages of acute evolving myocardial infarction (AMI) were assigned to receive high-dose...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(85)80283-3
更新日期:1985-05-01 00:00:00
abstract:STUDY OBJECTIVES:The objectives of this study were to assess the efficacy of parenteral magnesium sulfate (MgSO4), digoxin, and combined MgSO4-digoxin therapies in acutely lowering ventricular rates in patients with newly recognized atrial fibrillation. DESIGN:A randomized, double-blinded, placebo-controlled clinical ...
journal_title:Annals of emergency medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0196-0644(94)70163-6
更新日期:1994-07-01 00:00:00
abstract::Varicella (Chicken pox) is a contagious disease common in childhood but uncommon in adulthood. Pneumonia, however, is a relatively common complication of the disease in adults. Recognition of the potential for this complication in adult patients with varicella is essential for the emergency physician. Three cases of v...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(86)80679-5
更新日期:1986-08-01 00:00:00
abstract::A prospective, randomized study of 500 consecutive emergency department patients with traumatic lacerations requiring sutures was performed comparing use of topical 1% povidone-iodine (Betadine) and scrubbing with wound management by irrigation with normal saline without scrubbing. A 60-second wound irrigation and scr...
journal_title:Annals of emergency medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0196-0644(87)80008-2
更新日期:1987-02-01 00:00:00
abstract:STUDY OBJECTIVE:To investigate whether the addition of a single aerosolized dose of glycopyrrolate leads to a greater improvement in pulmonary function than treatment with albuterol alone for patients with acute exacerbation of chronic obstructive pulmonary disease (COPD). DESIGN:Prospective, randomized, blinded, cont...
journal_title:Annals of emergency medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0196-0644(95)70260-1
更新日期:1995-04-01 00:00:00
abstract:STUDY OBJECTIVES:To reappraise Boehler's angle and evaluate factors, including centering of the central beam, sex of subjects, and side of the body, that may affect angle measurement. DESIGN:Retrospective clinical review. SETTING:Emergency department, Level I trauma center. TYPE OF PARTICIPANTS:120 consecutive patie...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(05)81206-5
更新日期:1991-02-01 00:00:00
abstract:STUDY OBJECTIVE:Apnea is a known complication of pediatric seizures, but patient factors that predispose children are unclear. We seek to quantify the risk of apnea attributable to midazolam and identify additional risk factors for apnea in children transported by paramedics for out-of-hospital seizure. METHODS:This i...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2013.09.015
更新日期:2014-03-01 00:00:00